T and T: Action plan to fight SARS

From today, an emergency response plan to the highly contagious pneumonia-like disease, Severe Acute Respiratory Syndrome (SARS), takes effect at all public health institutions.
This includes holding bays to isolate patients suspected of having SARS at district hospitals and mandatory use of protective gear by all medical staff, Ministry of Health officials disclosed yesterday.
The announcement of the strategy comes in the wake of a scare at the Port-of-Spain General Hospital on Sunday, where health workers donned masks for protection on learning a patient with symptoms similar to SARS had been admitted.
The patient, who works at Piarco International Airport, has since been discharged, but has been advised to return to the hospital if a fever develops, a Ministry source disclosed last evening.
The patient, a woman of East Indian descent, was taken to the hospital by the Emergency Health Services, having first been sent to the Arima Health Facility then to Caura Hospital.
The EHS personnel arrived wearing masks, the source said, which prompted medical staff at Port-of-Spain General Hospital to do the same.
Acting Chief Medical Officer, Dr Rampersad Parasram, yesterday said this reaction was a “precautionary” measure.
But the source attributed it to “a low level of preparedness and lack of communication”.
Parasram confirmed there were no cases of SARS in the country.
Outlining the plan, Parasram announced that Caura Hospital had been withdrawn as a quarantine unit because it lacks the equipment to provide proper ventilation support.
Caura was named by Health Minister Colm Imbert in Parliament, two weeks ago, as the quarantine unit for suspected SARS cases.
Instead, patients are now to be isolated in holding bays, until ready for transfer to either Port-of-Spain General Hospital or Eric Williams Medical Sciences Complex, which has the necessary ventilation support system for severe cases.
SARS patients in Tobago and San Fernando are to be transferred to these institutions.
Officials of the regional health authorities, along with Parasram and Principal Medical Officer, Epidemiology, Dr Ian Popplewell held a meeting to draft the plan at the Health Ministry in Port-of-Spain yesterday.
All institutions, as well as private practices, are to be informed about the plan and will work with one document, said Parasram.
EHS will also be briefed on guidelines for the transfer of SARS patients and how to sanitise themselves and vehicles after delivering a patient. They will also be mandated to wear basic protective gear.
Parasram said a combination of antibiotics will be used to treat patients with SARS. The drug, Ribavirin, will not be used as a frontline medication, as there was no evidence that it was necessary, said Parasram.

Ribavirin had been reported as being successful in one case of SARS.
Although Parasram said the Ministry has adequate supplies of protective gear, a source said only ordinary surgical masks were available and not the N95 masks recommended by the World Health Organisation.
Parasram admitted there was always an element of risk because of the high level of travel to and from the United States and Canada.
However, he said surveillance has been increased and the Ministry will work with both the Airports Authority and Port Authority.
Declaration forms with specific relevance to SARS will be issued.
Tobago, too, has been briefed and is to receive copies of the plan

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